| NPI | 1306164439 |
|---|---|
| Former Legal Business Name | MANGOSTEEN DREAMS INTL., LLC |
| Entity Type | Organization |
| Authorized Contact | CONNIE AMUNDSON Member 206-409-9447 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Enumeration Date | 2010-05-13 |
| Last Update Date | 2016-05-27 |